Common Symptoms

• Hand and wrist pain
• A burning sensation in the middle and index fingers
• Thumb and finger numbness
• An electric-like shock through the wrist and hand

These symptoms are often exaggerated when the wrist is bent forward. This numbness or pain may be worse at night, and may actually keep you awake. During the day, it may occur more often when you are participating in activities that involve bending of your wrist.

Common Causes of Carpal Tunnel Syndrome

Diseases or conditions that may increase your chances of developing carpal tunnel syndrome include pregnancy, diabetes, menopause, broken or dislocated bones in the wrist, and obesity. Additional causes include repetitive and forceful grasping with the hands, bending of the wrist, and arthritis.

Any repetitive motions that cause significant swelling, thickening or irritation of membranes around the tendons in the carpal tunnel can result in pressure on the median nerve, disrupting transmission of sensations from the hand up to the arm and to the central nervous system.

Diagnosing Carpal Tunnel Syndrome

It is important to seek medical assistance when you first notice persistent symptoms. Do not wait for the pain to become intolerable.

Before your doctor can recommend a course of treatment, he or she will perform a thorough evaluation of your condition, including a medical history, physical examination and diagnostic tests. Your doctor will document your symptoms and ask about the extent to which these symptoms affect your daily living. The physical examination will include an assessment of sensation, strength and reflexes in your hand.

If conservative treatment such as medication or physical therapy does not provide sufficient relief, your doctor may perform diagnostic studies to determine if surgery is an effective option. These diagnostic studies may include:

• Electromyogram and Nerve Conduction Studies (EMG/NCS): These tests primarily study how the nerves and muscles are working together. They measure the electrical impulse along nerve roots, peripheral nerves and muscle tissue.

Conservative (Nonsurgical) Treatments

Treatment for carpal tunnel syndrome may include rest, the use of a wrist splint during sleep, or physical therapy. Conservative treatment methods may continue for up to eight weeks.

When Surgery is Necessary

Only a small percentage of patients require surgery. Factors leading to surgery include the presence of persistent neurological symptoms and lack of response to conservative treatment.

The most common procedure is called carpal tunnel release.

Recovery After Surgery

After surgery, a dressing will be applied to your hand. You will notice that the pain and numbness begins to improve after surgery, but you may have tenderness in the area of the incision for several months.

Recurrence of symptoms after surgery for carpal tunnel syndrome is rare, occurring in less than 5 percent of patients.